ENG-SEWER APPLICATION-ENG20190401.pdfi*2ai10401
SIDE SEWER
PERMIT APPLICATION
CONTRACTOR INFORMATION:
Company Name: Echelbarger Homes & Land, LLC
Site Contact: Todd Echelbarger
Company Address: 4001 198th St. SW. #2
Phone #: 425.673.1100
City: Lynnwood Zip: 98036
Email #: Todd@Erhelbarger.com
State License # Echeli1905d6
City Business License # BL-010390
Expiration Date: 3.28.2020
PROPERTY INFORMATION:
Address:
720 13th Way SW Edmonds, 98020
Owner's Name:
Echelbarger Homes & Land, LLC
Phone #:
425.673.1100
® FULL LINE REPLACEMENT ❑ SPOT REPAIR
❑ PIPE BURST ❑ RELINE (PERMALINE ONLY)
DESCRIPTION OF PROPOSED WORK (Be Specific):
Connecting a new single family home to the existing side sewer stub on lot 1 of the Jenkins Lane plat.
ISSUANCE OF THIS PERMIT DOES NOT CONSTITUTE PERMISSION TO WORK ON ANY PROPERTY OTHER
THAN THAT OWNED BY THE SUBJECT PROPERTY OWNER.
CERTIFICATIONS NECESSARY FOR INSTALLATION METHODS ARE THE RESPONSIBILITY OF THE
CONTRACTOR PERFORMING SAID WORK.
I REPRESENT AND WARRANT TO THE CITY OF EDMONDS, IF REPAIR OF EXISTING SEWER EXTENDS TO AN
ADJACENT PROPERTY, I HAVE OWNERS EXPRESS PERMISSION TO PERFORM WORK ON THAT ADJACENT
PROPERTY.
SIGNATURE — DATE
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE RECEIVED
OCT 17 MIS
BUILDING